Renal Embryology

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Headshot of Henry Mroch, MD FACP, FASN · Professor
Henry Mroch
MD FACP, FASN · Professor
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Table of Contents

Multiple choice

Describe the following

Horseshoe kidney

Functional or Nonfunctional?

Functional

Multicystic displastic kidney

Functional or Nonfunctional?

Not functional

What is the concept of induction?

Prompting the uterus to contract during pregnancy before labor begins on its own.

What two tissues are involved?

  1. Uterus.
  2. Placenta.

A recurrent UTI in a child can be a tip off for what abnormality?

Vesicoureteric reflux (VUR)

How does a duplicated ureter form?

Abnormalities in the branching pattern of the ureteric bud results in a double ureter with a double opening into the urinary bladder.

Questions

Oligohydramnios is a disorder of amniotic fluid resulting in decreased amniotic fluid volume for gestational age. Low amniotic fluid volumes can be the result of numerous maternal, fetal, or placental complications and can lead to poor fetal outcomes.

Questions

Define the POTTER acronym.

Pulmonary hypoplasia

Oligohydramnios

Twisted skin (wrinkly skin)

Twisted face (Potter facies: Low set ears, retrognathia, hypertelorism).

Extreme deformities (limb deformities: Club hands and feet, join contractures)

Renal agenesis (bilateral); restricted growth (IUGR)

Describe why the lungs don't develop in POTTER syndrome.

Sufficient chest expansion is required for lung development. Also, amniotic fluids provide proline for lung development. Fetal compression by the uterus and fetal intraabdominal organ pressure on diaphragm cause failure of thorax expansion, which keeps alveoli and airways collapsed.

Describe the primary event leading to renal agenesis.

Renal agenesis occurs when one or both kidneys completely fail to form. This usually occurs at approximately 4 to 6 weeks into pregnancy and is due to failure in the earliest steps of kidney development.

When I hear "frequent antibiotic does for a UTI," I think:

Understandably many women do not like the idea of being on long-term antibiotics. However, this is often much safer and healthier than suffering from ongoing infections. In many women a course of preventative antibiotics used over several months can help break the cycle of frequent UTIs for many months or even years.

Imaging tests

Questions

What is the relative cost of a CT scan abdomen vs. ultrasound abdomen?

CT scan abdomen: $166–$3,159.

Ultrasound abdomen: $797

A helpful modality for imaging kidneys is:

Multi-slice CT scan.

If a neonate/infant is born with respiratory distress, name a potentially useful imaging test.

The current diagnostic reference standard includes clinical testing and chest radiography with associated exposure to ionising radiation.

Questions

Those with Turner syndrome or Trisomy 18.

Inferior mesenteric artery at L3.

PALMD and IL6 polymorphisms

The Kidneys

Question

Name three common sites for narrowing of the ureter.

1

The ureteropevic junction (UPJ).

2

The ureteral crossing of the iliac vessels.

3

The ureterovesical junction (UVJ)

Question

What part of the kidney is rich in glomeruli?

Cortex; each kidney contains approximately 500,000 glomeruli.

Name the arteries giving rise to the glomeruli.

  1. Renal artery.
  2. Lobar arteries
  3. Arcuate arteries.
  4. Afferent arterioles.

Why would it matter where the arteries are located regarding a renal pelvic kidney stone?

Many women do not like the idea of being on long-term antibiotics. However, this is often much safer and healthier than suffering from ongoing infections. In many women a course of preventative antibiotics used over several months can help break the cycle of frequent UTIs for many months or even years.